Back
Natalie Douglas
Independent Board Director, FarmaMondo Group

Patti's People - Patti Peeples speaks with Natalie Douglas and Ragan Hart - Part 2

🎥 Jun 24, 2025 📺 Becaris Publishing ⏱ 51m
In Part 2 of this 'Patti's People' episode, Patti Peeples of the The Peeples Collaborative speaks with Natalie Douglas, Founder and ...
Watch on YouTube
Transcript (34 segments)
P
Patty0:17
So, Natalie, you serve in a variety of NED roles as well as on boards, as do you, Reagan. But talk to me a little bit about when a founder should advance to setting up a formalized board, with or without NEDs. What is the decision path and what is the construct of that external advisory group?
N
Natalie Douglas0:44
In my experience, most boards get formally structured at the point when external investment comes in. Investors tend to insist on some board structure. I've found that when joining a board, there are already non-executives; in early stage businesses, they tend to be people the founder trusts, who may not bring industry experience but could be a subject matter expert in finance. Also, bringing advisors who are part of the team together—subject matter experts, global-leading experts—can add weight for the investment story, customers, and the young team. So you're evolving into setting up your first board, which varies depending on who the investors are. You need to think about how to structure the board and how that structure may change over the growth journey. The board you start with is not necessarily the board you'll need at year three or five. As a general rule, start thinking about how the board will be structured and what will be useful for you.
P
Patty3:22
Yeah. Cover them.
N
Natalie Douglas3:24
So one of the biggest issues I find is a complete lack of independence, common on private equity and VC boards where you have representation from every investor. So the first important thing is to bring independence to the table. Having a chair from an early stage is important too, because that gives you a mentor to help navigate the tricky journey with investors. The chair supports the CEO and also supports investors, sometimes pushing back, but mainly acting as a collaborator to bring cohesion. There are tricky moments, but I've navigated many as a CEO and founder. So the independent role is vital for both investors and management.
P
Patty5:12
Reagan, continuing this view of an advisory group and a board, give me some examples. Let's say it's a company that has a technology in the real world evidence space. What would be some typical functionalities that you would seek as a founder in your set of advisers and eventually a board?
R
Reagan Hart5:36
Well, I think it's a good distinction: there are subject matter experts as advisers on an advisory board, and distinct from that, a formal board serves as the fiduciary for corporate governance. At early stages, the advisory board is sometimes conflated with the accountability board, which is a misappropriation. For the question of functionalities using the example of a tech-enabled RWE business, it comes back to the anticipated milestones for the next 12-24-36 months. You need to enable capital investors or board members who can help get the company there based on their network and portfolio. At earliest stages, we don't want too large boards because the CEO then has to manage competing points of view. The composition should grow with you; you need to identify blind spots and engage board members to say, 'This is a risk, can you help augment this capability?' The board members will either be honest or not, and that can help or disable the business. For example, when a strategic acquisition opportunity arises, you need to augment expertise but cannot substitute someone without the expertise. Hard conversations when a board member is no longer serving the company's best interest require engaging other board members for a succession plan. As CEO, be as honest as possible with your board so they can mitigate risk. Qualifying investors involves teasing out rapport; some investors show up differently pre- and post-investment. Leverage ecosystem resources to talk to founders who have taken capital from investors to learn how they showed up in the boardroom. Do your homework because that's critical in your darkest hours.
P
Patty11:11
More often than not, the answer is no to funding or investing. When one gets a no, what should a founder do with that? How can they turn that no into a better pitch? How can they establish a flow of information that helps them move to a better next stage? Natalie?
N
Natalie Douglas11:35
Getting a no is highly likely for any founder; it's inevitable and a good learning opportunity. Determine if it's an absolute no or a not-yet. They are very different. We're going through this with one of our investments; it's more not-yet than no. Nos are powerful because most investors will tell you why. Sometimes it's just not the right investor, you didn't do your homework, or they invested in a competitor. Try to get feedback from investors: ask how you pitched, what was good, what was not. Determine if it's no or not-yet. Not-yet gives you opportunity to improve and come back when you've met additional boxes.
P
Patty13:35
Reagan, you've brought up the term authenticity, which is so important from some of those early connection points. On the other side of the coin, is the investor also showing up authentically, and how can you lean into that?
R
Reagan Hart13:55
The investor sentiment is that we take a predatory view, but there are investors who are not authentic. It's up to you to decide whether to spend time with that type. Recognize that there are counter investor groups trying to enable great businesses. It comes back to engaging and sussing out impressions from brief interactions. Look at the portfolio companies they've invested in. Reach out to founders and operators who have worked with those investors to get reviews. Context matters: is this a three-year relationship? It's never three years; it's much longer. In limited interactions, capture sentiment by the thoughtfulness of their questions. Are they asking intellectually curious questions about your business? Assess different investors based on the questions they ask; it's an indicator of the value they might bring.
P
Patty17:24
Natalie, let's go to you with digging down into some of the nitty-gritty. Let's talk a little about due diligence. I know you conduct a lot for organizations and private equity groups, and it's one of your favorite things. Can you level set what due diligence is for founders who may not have a sense of the construct, and what should they be prepared for?
N
Natalie Douglas17:51
Due diligence is a big topic involving multiple players. It's an external view of your business model and the world it operates in. Depending on deal size, there could be multiple consultants, investment banks, and you might be involved operationally challenging management. You get to meet the team and dig deeper into management's competence. Due diligence spans commercial, financial, legal, regulatory aspects. As a subject matter expert, I sometimes do early-stage due diligence. When a founder is in front of an investor, they likely already have a data room. Investors will do a lot of research on your business model, but can only determine so much from you. It's tiring and time-consuming and can distract from running the business. The ante increases as you get closer to the deal. It's an arduous process but a great learning curve. For first-timers, it can be anxiety-inducing. But if you know your business well, are confident in your numbers, and believe in the future, that will come through.
P
Patty21:22
Reagan, what have you learned over the course of going through this process with multiple companies, and what are some tips you would offer for founders?
R
Reagan Hart21:34
Tips: ask the firm about their typical diligence timeline—two weeks, four to six weeks, a quarter? That gives you an indication of stage gates. Set up a data room with core materials spanning financial, regulatory, legal, corporate governance. Then, investors will request different materials. Understand why the investor is asking for a particular material; you might have other collateral that speaks to it. The investor is trying to derisk with limited time. How you show up—demonstrating competency and confidence in your business, market, and learnings—is key. Package information consumably.
P
Patty24:18
Uh, when you said consumable information, it makes me smile a little bit. Of course, coming from a research background, completeness and depth are ingrained in my DNA, and my advisor kept triggering me in this process. Enough is enough, Patty. You know, I really wanted to demonstrate the depth, but it was too much. So there's both sides to think about. Exactly. But too much in that context, right? Because in another context, we might say, 'Hey, Patty, please tell me more.' True. Exactly. Natalie, you work across several geographic locations with due diligence. Does it differ at all?
N
Natalie Douglas25:12
I'm not sure it differs per se. I think there's a general perception about US vs British investors, but I don't see that much difference geographically. I see differences in size between PE and VC. Structuring of deals might be slightly different, but in general, most investors today, especially PE abroad, and we see American investors looking at European business models. Behavior and ambition differ, but the way they conduct diligence or evaluate business models is not that different in my experience.
P
Patty26:27
Well, tell me more about the differences in behavior and maybe the type of deals and how they would structure. How does that specifically differ geographically?
N
Natalie Douglas26:37
That's a tough question, Patty. It depends on many factors. But general perceptions: there's a lot of activity in European medtech, with real smarts. The marketplace is broader than it used to be. For a UK business looking for funding, perception is there's more money in the US, check sizes bigger, valuations greater, speed and efficiency, less bureaucracy. These are generalizations at a time of major shift in healthcare investing. Even though the US is a huge market, you must consider how technology applies globally. There's more global ambition today than 10 years ago. Mid-market private equity used to stay in the US, but now you see European PE firms in Shanghai, New York, San Francisco. The process per se is not different; there's still strong due diligence. Maybe American investors will insist on FDA approval before investing in European technology.
P
Patty30:04
Uh, do you think that in your experience, let's say a founder went through the acquisition process of their company? I had read that about 80% of founders were disappointed after the acquisition. Does that jive with your experience, Reagan? And how are we getting that so wrong? Why does that happen?
R
Reagan Hart30:33
I think it comes back to the acquisition process itself. It's nice to feel wanted before the deal, but post-acquisition, depending on terms, you lose autonomy and control, and you don't have the board you built. That conflicts with what seemed like an accretive integration. People are challenging. There is opportunity to think through terms about how long you're required to stay with the new buyer. Pluses and minuses. Maybe you gain information that the deal value wasn't as good as you thought based on new information. But it's still an accomplishment to have matured an asset to the point someone else was interested.
P
Patty33:17
That's a really excellent final point. Natalie, what do you have to add to that if anything?
N
Natalie Douglas33:22
I agree with everything Reagan said. In a nutshell: you got a new boss. It doesn't matter if you maintained majority stake. That comes with greater scrutiny, less autonomy, less blue sky, more rigor and detail, focus on bottom line. Healthcare businesses are altruistic, but suddenly investors are all about bottom line. That can be a disconnect for employees. Governance changes the dynamic. Set expectations at the time of the deal; know what to expect on day one. Also, in market access and RWE businesses, many acquisitions have earnouts, so founders become more like employees. You might still be the driver but cannot do it in the same way.
P
Patty36:09
Uh, so many founders are accidental entrepreneurs. I know each of you work with researchers who had a good idea, turned it into a company, but they are still researchers at heart. Reagan, you alluded to your scientist DNA. That's hard to excise. But one challenge for many founders is how to scale from zero to one and one to 100. The investor has to work with these sticky situations. What are some challenges you've experienced on that side, and could you highlight pitfalls or avenues to success for founders in that scale-up opportunity?
R
Reagan Hart37:15
The practices that got you from zero to one are not what will unlock execution for scaling. So it comes back to who you hire to augment experience. A blind spot is founders not reflecting on whether they are still the best CEO to take the company. With a great board, there will be conversations about bringing in additional competency. Receive that with humility. It's in the best interest of scaling, but it can be a point of pride. So be able to speak with your board advisors about what worked well and how to leapfrog. Bring different voices into the room. As the executive team, you're mired in survival and may not take enough time to identify organizational blind spots that could get you to the inflection point.
P
Patty39:45
Yeah, you've built a strong relationship with your startup board, and it can seem daunting to change the construct as you move into the next stage. Natalie, do you have anything to add? And also, maybe you can talk a little about board communication styles.
N
Natalie Douglas40:04
I'd like to add to Reagan's points. The point of having a board is to rely on and help navigate challenges. As founder, the minute you bring in investors, your business changes; you're not the only person in charge. It becomes an organization requiring collaboration to move forward in the best interests of all shareholders. One of the hardest challenges is the change of team; often the founder may need to step aside or find a different place in the organization. That conversation needs to be had with investors early on. The advantage of having a board, especially a good chair, is that they can navigate that conversation. Board composition is fundamental; you can augment lack of commercial experience in the boardroom. Recognize that different board members have different incentives based on their fund size. For example, a first-time fund will influence decisions differently than patient capital with a longer time horizon. That tension plays out in boardroom, and you as CEO have to manage it.
P
Patty44:48
Uh, Natalie, have you had any experience with a board and a CEO/founder where there was a mismatch in the type of communication, the depth of communication, that you could describe for our audience as essential components for a CEO, a founder to operate in a way that maximizes the board's effectiveness?
N
Natalie Douglas45:25
I've been on a number of boards; most have been great experiences. Being a non-executive is enjoyable working with up-and-coming founders. Factors for founders: need to be receptive to feedback, respect others' opinions, and be transparent with the board, especially with the chair. It has to be an honest and trusting relationship. I've been in situations where trust was misplaced, leading to tricky situations not healthy for the company. Some founders can be difficult to work with; that can be why investors won't invest. They are not open to feedback or transparent. There's nothing worse than surprises. As a NED, you have to choose who you work with. Bad behavior often comes from lack of experience, naivety, ignorance, or arrogance. Our job is to determine which it is.
P
Patty48:58
Well said. Let's move to some final thoughts. I'd like for each of you to wrap up with three main takeaway messages for founders and investors in this arena. Reagan, let's start with you.
R
Reagan Hart49:17
My three main messages for founders and investors: do your diligence on the investors you want to pitch with, find warm connections for warm intros, and ensure your pitch is consumable and digestible to a naive audience. You know your business better than anyone else. Help us appreciate that.
P
Patty49:47
Beautifully said, Natalie.
N
Natalie Douglas49:50
Those are great takeaways. I'm going to try to be as eloquent and as smart. Go into the process with open eyes. Do as much as you can to understand the process you're about to undergo. It can be a fantastic experience; many have come out the other end having gained value and grown amazing businesses. But be open to the challenges. The good, the bad, the ugly. It's an uncomfortable alliance. Plan for that uncomfortable alliance and you'll be prepared. Finally, set expectations very clearly with the investors you're going to work with. Make sure you're aligned before signing the paperwork. Know what to expect as a founder from day one, and know your obligations. From an investor point of view, set the team up for success. Give them support and make sure the board isn't stuffed with people who aren't helpful. Was that more than three, Patty?
P
Patty51:14
It was fine. Well, we've come to the end of today's conversation. I think it's been incredibly rich and informative, built on a depth of experience that both of you bring to the table. I want to thank you so much, Natalie Douglas and Reagan Hart, for being so transparent and authentic and providing us with some really good tips and tricks no matter what side of the aisle one sits on. Thank you very much.
N
Natalie Douglas51:42
Thanks for the opportunity. Great to spend time with you as well, Reagan.